1. Epidemiology and Global Health
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Quantifying antibody kinetics and RNA detection during early-phase SARS-CoV-2 infection by time since symptom onset

  1. Benny Borremans  Is a corresponding author
  2. Amandine Gamble
  3. K C Prager
  4. Sarah K Helman
  5. Abby M McClain
  6. Caitlin Cox
  7. Van Savage
  8. James O Lloyd-Smith
  1. University of California, Los Angeles, United States
  2. National Marine Mammal Foundation, United States
Research Article
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Cite this article as: eLife 2020;9:e60122 doi: 10.7554/eLife.60122

Abstract

Understanding and mitigating SARS-CoV-2 transmission hinges on antibody and viral RNA data that inform exposure and shedding, but extensive variation in assays, study group demographics and laboratory protocols across published studies confounds inference of true biological patterns. Our meta-analysis leverages 3,214 datapoints from 516 individuals in 21 studies to reveal that seroconversion of both IgG and IgM occurs around 12 days post symptom onset (range 1-40), with extensive individual variation that is not significantly associated with disease severity. IgG and IgM detection probabilities increase from roughly 10% at symptom onset to 98-100% by day 22, after which IgM wanes while IgG remains reliably detectable. RNA detection probability decreases from roughly 90% to zero by day 30, and is highest in faeces and lower respiratory tract samples. Our findings provide a coherent evidence base for interpreting clinical diagnostics, and for the mathematical models and serological surveys that underpin public health policies.

Article and author information

Author details

  1. Benny Borremans

    Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    For correspondence
    bennyborremans@gmail.com
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-7779-4107
  2. Amandine Gamble

    Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
  3. K C Prager

    Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-0669-0754
  4. Sarah K Helman

    Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
  5. Abby M McClain

    National Marine Mammal Foundation, San Diego, United States
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-5000-4198
  6. Caitlin Cox

    Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
  7. Van Savage

    Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
  8. James O Lloyd-Smith

    Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, United States
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-7941-502X

Funding

H2020 Marie Skłodowska-Curie Actions (707840)

  • Benny Borremans

Defense Advanced Research Projects Agency (PREEMPT D18AC00031)

  • Amandine Gamble
  • James O Lloyd-Smith

UCLA AIDS Institute and Charity Treks

  • Amandine Gamble
  • James O Lloyd-Smith

National Science Foundation (DEB-1557022)

  • K C Prager
  • James O Lloyd-Smith

US Department of Defense Strategic Environmental Research and Development Program (RC‐2635)

  • K C Prager
  • James O Lloyd-Smith

Cooperative Ecosystem Studies Unit (Cooperative Agreement W9132T1920006)

  • K C Prager
  • James O Lloyd-Smith

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Talía Malagón, McGill University, Canada

Publication history

  1. Received: June 17, 2020
  2. Accepted: September 4, 2020
  3. Accepted Manuscript published: September 7, 2020 (version 1)

Copyright

© 2020, Borremans et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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